CMS Formulary

Displaying 138661-138670 of 1611142 results.
ID: 138661
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966397
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138662
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966188
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138663
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966410
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138664
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966197
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138665
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966399
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138666
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966208
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138667
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966214
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138668
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 352044
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138669
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 352045
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138670
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 352046
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0